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VALLI VUE ESTATES #2 BLK 6 LT 3
Onsite File Ak ' x: k Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191283 I PID Number: 015-123-15 Dwelling: ❑e Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New X Upgrade Name: Joyce Zimmerman -Golden ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 6621 Round Tree Drive Anchorage, AK 99507 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 306-7526 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Valli Vue Estates #2 6 3 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Fe Ft. Well >200' N/A N/A NSA >25' TANK ❑m Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1,250 Gal. Surface Water >100' N/A N/A N/A Material Number of compartments Lot Line >5' N/A N/A N/A Plastic 2 NA Foundation >10' N/A N/A N/A LIFT STATION Manufacturer Capacity i Curtain Drain None j Noted Gal. Remarks Tank replacement only. Pump on level at in. Pump offlevel at. in. High water alarm at in. Tank Serial No. 1784 Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield Installer Isaac's Excavating Drainfield D3034 co/MT Inspector J. Mlllette BENCH MARK (Assumed elevation) 100 ft Inspection1s' 7/25/19 Location and description dates: 2ntl 3" 4th Bottom of siding @ point A COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Ott '��:q���� Conditional Approval: Date" • 49th �: .......... .. �,..�..:.z... ....,.......ttw,e.la...o.s.n.,..l.w..6� MICHAEL E. ANDERSON �cr a S ^� `I�e® No. CE -4381 7/26/19 °.•°°° tt��® FO ......x-• 4P Appro Date inspection Reporl_a--i-iz.aoc VALLI VUE ESTATES #2, BLOCK 6, LOT 3 PERMIT # OSP 191283 PID # 015-123-15 / / LOT 2 o \ �pJ i LOT 3 EXI ING " AB PT ON TREN SV MH c NEW 1250 -GAL SEPTIC TANK \ Ck J 0 LOT 4 EXISTING WATER SERVICE SHED / LINE. LOCATION CONFIRMED I I l � I I � EN GIN lEAIHG 1 50 100 .§fi` MM MM::j FEET LOT 32 / LOT 31 I PATIO A B CO 10.0 21.6 MH 15.3 19.5 SV 19.4 18.1 MT 16.6 15.9 2CO 22.6 18.4 LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE VALLI VUE ESTATES #2 B6 D :4 ►l I I WON 61 a • I WON EN GIN EEAIHG PID # 015-123-15 (NO SCALE) V V."Y MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PQ Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 htip://www.muni.orgionsite On -Site Wastewater Disposal System Permit Permit Number: OSP191283 Work Type: SepticTank Upgrade Tax Code Number: 01512315000 Site Legal Address: VALLI VUE ESTATES ##2 BLK 6 LT 3 G:2539 Site Mailing Address: 6621 ROUND TREE DR, Anchorage Owner: ZIMMERMAN-GOLDEN JOYCE Design Engineer: FORGE ENGINEERING This permit is for the construction of: 0 Disposal Field Q Septic Tank ❑ Holding Tank. O Privy Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 7/11/2019 7/10/2020 23303 ❑ Private Well D Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation_ The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (2417). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Issued = Date: Date: r / f% bl 4 MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-123-15 Property owner(s) Joyce Zimmerman -Golden Day phone 306-7526 Mailing address 6621 Round Tree Drive Anchorage, AK 99507 Site address Same Legal description (Sub'd., Block & Lot) Valli Vue Estates #2, Block 6, Lot 3 Legal description (Township, Range & Section) Lot Size 23,303 Sq. Ft. Number of Bedrooms Four (4) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank IRUpgrade ❑X Duplex (D) ❑ Holding Tank ElRenewal ElMultiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 4070?s 00 Waiver Fees: Date of Payment: -OMID 5 o Date of Payment: Receipt Number: ����J �� U gq�� ID Receipt Number: Permit No. lJ1 119 9 J Waiver No. Permit App_- :- : '., c —o� P Ln�j PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) July 11, 2019 MOA Development Services Department On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Valli Vue Estates #2, Block 6, Lot 3 – 6621 Round Tree Drive Septic System Design Dear On-Site Services Engineer: The septic tank on the subject lot has failed and must be replaced. We are submitting this design and permit application for the construction and placement of a new 1,250-gallon septic tank. The attached site plan identifies the location of the home and the existing septic system along with the new tank location. The lot and subdivision are served by a community water system. No conflicts exist between this proposed tank and any other well or septic system in the area. The new tank will be constructed a minimum of 200’ from any well in the area. It will also be 100’ from surface water and more than 5’ from the existing absorption trench, 10’ from the house foundation and 5’ from deck or stair supports. Please refer to the attached plan sheet for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Michael E. Anderson, P.E. 7/11/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191283, Rebecca Carroll, 07/11/19 x x xEXISTING ABSORPTION TRENCH.2CO 10050 0 FEET 1"=50' 4-BDRM HOME NOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM SURROUNDING LOTS ARE ALL ON A COMMUNITY WELL SYSTEM. CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND VALLI VUE ESTATES #2, BLOCK 6, LOT 3 ROUND TREE DRIVE7/11/19 10' UTILITY EASEMENT1 0 ' D R A I N A G E E A S E M E N T SHED PATIO REMOVE EXISTING 1,500 GALLON SEPTIC TANK PER MOA CODE. PLACE 1,250 GALLON SEPTIC TANK w/20" MANWAY 10' FROM HOUSE FOUNDATION AND 5' FROM DECK AND STAIRWAY SUPPORTS. SV MH EXISTING WATER SERVICE LINE. VERIFY LOCATION PRIOR TO CONSTRUCTION. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191283, Rebecca Carroll, 07/11/19 FA PJ�op / o ^ry v / / N 22'41'02"E 10.00 Lot 4 SEPTIC PIPES 4.0' \ T10' DRAINAGE '"\/ EASEMENTS \ \ \ Lot 2 \ Lot 3 23,303 s.f. 2 STORY RESIDENCE 10.2' z 10.3' 10' UTILITY EASEMENTS ASPHALT PAVEMENT FENCE I I � 9.9, x 14.6, WOODEN PATIO PLOT PLAN AS BUILT X SCALE —11 330' GRID SW 2539 Project No. 19-306/A1 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone oop�pp�� (907) 522-4625 Fax o 0 F A k' Professional Land Surveyors kenOlongsurvey.com cC r •. . 9 Q jonafhanOlangsurvey.com �4 \ .• S 04 I hereby certify that I have surveyed the following described properly: Lot 3, Block 6, VALLI VUE ESTATES UNIT No. 2 (Plat No. 77-296) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no Improvements on the properly lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. Dated this the '" Day of Tvr-c ° at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. P 49....T.. H p KENgar y4:F 0 W'?FrSSI0NA1- �o r . I I I I � 9.9, x 14.6, WOODEN PATIO PLOT PLAN AS BUILT X SCALE —11 330' GRID SW 2539 Project No. 19-306/A1 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone oop�pp�� (907) 522-4625 Fax o 0 F A k' Professional Land Surveyors kenOlongsurvey.com cC r •. . 9 Q jonafhanOlangsurvey.com �4 \ .• S 04 I hereby certify that I have surveyed the following described properly: Lot 3, Block 6, VALLI VUE ESTATES UNIT No. 2 (Plat No. 77-296) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no Improvements on the properly lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. Dated this the '" Day of Tvr-c ° at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. P 49....T.. H p KENgar y4:F 0 W'?FrSSI0NA1- �o . MUNICIPALITY OF ANCHORAGE .-~-. RTMENT OF HEALTH AND HUMAN SER Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, TeJephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT N~,.e/Y/,/~,~ ~1~~ DISTANCES SEPTIC ABSORPTION Address WELL ~Zt ~OU~ ~ TANK FIELD Phone(s) ~--~5 (~ PermJtNO WELL ~4~-ue¢(~om~- ~7oo2o .oo,~oo~ ~2~~ +200~ ~[GAL OESCRIpTION LOT LINE Lot ~ IB,oc~& JSubOi~i~°' VA~ gOff FOUNDATION ~/&~ ~ ~ ~ ~) ~ I~ drlveway,AS-~UJLTwatergJAGRA~bodies, ~t~(Sh°w~ location of well, septic system, property hnes, Ioundatlon, TANKS ~.~ ~. / ~ ¢ SEPTIC 0 HOLDING ~ '> .,, N ~ I ~00 ~TRENCH ~ ~ W. DRAIN ~OTHER FiJladdedaboveodglnalgrade~o~. FT Gr~veldepthber, eathplpe ~, F~ ~ ~ Total abso,ptmon area Dimance between lines ~-'~ ' ~0 gQ FT ~ Fl ' · Number ol lines Sol~r;nb Pipe mater,s, t (' )ate InstalJed : WELLS PRIVATE OTHER fldentifv) Date: ~unidpal a~ 8tale guidelines in ellecl on this dale: ~ ~ %0, .~ .~ Health Department Approval: ~ ~ Date:~- ~ 72-013 (3/85) March 17, 1987 ~O ~iOM IT MA~ ODNCBRN: Isaac's Honey Wagon will b~ responsible for maintaining the "Zabel" filter installed on the septic system for Lot 3, Block 6, Valli Yue Subdivision. Issac's has provided septic tank pumping services for this lot for many years and will remove, clean, and reinstall the filter on an annual basis. Isaac s Honey agon BL. UC~:: 6 , ,.ii ~..1l ~..~¥. l.'.h~e I~ ,.i .. ~l.~: ]. J-. '1'.¥,.. c:,~' ?d-iC:!'-JC:,PaC:IE' (i'"IC)(-~) ,:: ......., ,. Lhce [{?[.ai'[.E' ~.~-- ~" .~. ~'.~:i. '-'" Ala~J-::a r'equ~pemeJYLs ~ (::)t'. th(<, se'L back .m any exisLing we} ]., was'Leu~a'Lev disposal.:~' ......... ,,~:, e, oJ" ..nl~...:i.c :i:)::: A L:):F'3" S'f'A'F'ION IS INS'FAL. I._ED ]:ix) AN AF:.:EA []OVEF~f~{D BY MOA BUZI...DING CODES~ ]HEN (1) AN ELI~X:;]R]:CAL. PERM]:T' AND ]:N~F'ECT:[ON MUST BE OBTA!NED~ (2) AS'-"BU:[L.]'S WILL.. NO] BE APF:'ROVED WZ'THC)LVF AN ELECTRICAL. ZNSF'EC]"ION REPORT~) hND (3) '['HE l~) I:::['-FRZ 'A "~ ~::: '" ¥ :::'~ q:: '- ix "~ ~:" '~ ............... f'''''''''''~'''''~ x .......... · ~d,,.i.. iu..,.~l )...~-.. DCI.E ~ ~.~ b..d..,,=.l,lc~ED L/ .... ............................... ....... 2 3 4 5 6 7 8 9 13- 14 '15 - 16- 17 18 19 20 BF. E EPPS & PO'i-rs ENGINEERING, PLANNING, SURVEYING SOILS LOG -- PERCOLATION TEST ~J/~P - Township. Range, Section: "T"J ~., J~ SLOPE SITE PI.AN ENCOUNTERED? IF YES, AT WHAT DEPTH? E MomterJflg? DaI~ Gross Net Depth to Net Reading Date Time Time Water Drop fZ o:oo o:oo o I, :0(o : c)(, I o' - JO,~" I" &, O " :l~ :~7 I1' ' 0" ~.~ " :~1 :o~ I0'- lAC' t.~" ~,0 " :~-P, :Zl I1'- ~" Z,~" ~,(~ ,, I:OZ : lo IO'- u.~' ~.3" 6.~ .I I: 12 : lO I1' - 0.~" I,~" ~.O O I =~ ',10 II'~ ~q 6.1 ~ 1:3% :~O I1'- g;l" 51L...T',/,'~,J~ L Gn'l ~tq0 I4oL~ COMMENTS '7,2. ~ ¢~1:~2. :IO ti'- jg.n I :~..:' PERCOLATION RATE 1. J ' Im~nutes,-mch) PERC HOLE DIAMETER TEST RUN BETWEEN lO, ~ FTAND 11,5 FT ~---~'7/ ;'~""~-J~'- J ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ,N EFFECT ON THIS OATE. ~)ATE. ~* F~-'~-~ ~7 TRENCH DIMENSIONS REQUIRED: WIDE SCREENED ROCK DEPTH LENGTH PROPOSED TRENCH DIMENSIONS: WIDE scREENED ROCK DEPTH LENGTH COVER EFFECTWE AREA OF PROPOSED TRENCH: 7~.(~ ,~ COVER TOTAL DEPTH TRENCH SECTION: PVC WffH IXlC BARRIER 4. DRAiNFiELD PIPE SCREENED ROCK STANDPIPE DETAIL: ~STANDPIPES TOTAL / TO BE CONNECTED AS SHOWN ON LEFT NOT TO, BE CONNECTED AS SHOWN ~ TRENCH SECTION PER M.O.A. HEALTH DEPT. STANDARDS ORD. 15.65 // QGR/ ~. ANCHORAGE AREA Brr~'mH Department of Environmental Quality 3500 Tudor Road Anchorage, Alaska 99507 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION ~O".2,~'/) "r'P~¢~- o¢.~ g//72¢c/~g.,,.¢ LEGAL DESCRIPTION /07- L~ ,~,/-,'~' ~ ~/¢~, ~,//J~- "~/'~' ~ SEPTIC TANK: DISTANCE FROM WELL NUMBER OF MANUFACTURER k~.'/L~Q-~C &/~2::Z ~]) . MATERIAL 8~'~-,~ U ~:¢'[Z~,~/5 COMPARTMENTS INSIDE LENGTH -- INSIDE WIDTH ~' LIQUID DEPTH ' LIQUID CAPACITY /~00-~ GALLONS. SEEPAGE PIT: NUMBER OF PITS / DIAMETER_-~ ORWIDTHC¢~,~/~-~ LENGTH/x`/. DEPTH LINING MATERIAL2f~--oAIoP'-gT~¢'- CRIB SIZE: DIAMETER'e/~.DEPTH ~ DISTANCE FROM: BUILDING FOUNDATION ~¢ , NEAREST LOT LINE ~0 ~ . TOTAL EFFECTIVE WELL ABSORPTION AREA (WALL AREA) ~-¢~ SQ. F-T, ADDITIONAL ABSORPTION WELL: TYPE ~'O[[?/')')g/~/l"~/ CONSTRUCTION / BUILDING NEAREST FOUNDATION LOT LINE CESSPOOL _ , OTHER SOURCES APPROVED / DISAPPROVED NEAREST SEWER LINE REMARKS DEPTH DISTANCE FRO~f: SEPTIC SEEPAGE TANK SYSTEM DISTANCES: ',~h~OcoA/ PIPE MATERIAL: ~/..Z O~.S~ )¢O~ LOT SLOPE: REMARKS: ~¢ DIAGRAM OF SYSTEM -.~ ,4/ DATE ~JOV, ?., 1~Tg APPROVED ~/~/~J-~ ~t. ~¢l.A~ G.A.A.B. Form pWo026 GREATER ANCHORAGE AREA BOROUGH SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT · , INSTALLATION OF: S[PTI6 TANK ~EEPAGE PIT-- , DRAIN Fl~gD ,, OTHER NOT~% THIG PERMIT I$ NOT VALID WITHOUT DOM.LET,O. pAT, ANT'D'RATEO PFRHTT VAI TD flNF TI:AR FINAL IN~PECTION~ E4 HOUR NOTIC~ REQUIRED, BACKFILLING OF ANY ]By~TEM WITHOt~T FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL ]BE EU]BJECT TO pROSECUTION, SSPTID TANK SIZE BINIMUM DI]BTANCE~, REQUlREMENT~ ~EPTIC TANK TO ~EEPAGE PIT WALL ~ ~ · DRAIN FIELD .... J~ ~ ALSO CON~IDER AREA WATER MAIN TO SEPTIC TANK ~0 ~e : ~EEPAGE PIT DRAIN FIELD [0 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTg OF (~REAYER ANCHORAGE AREA I:IOROUGH ORDINANCE NO, 2~,E8 AND THAT THE ABOVE ~AVE~. ~A(;KFILL Civil Engineers [NGIb EERING & GEOLOGIC CONSULTANTS 22g EAST 51st. AVE. - P.O. BOX G087 - ANCHORAGE, ALASKA gg503 TELEPHONE 907-279-0483 TELEX 090--35419 Geologists Land Surveyors JAMES W. ROONEY, P. E. MALCOLM A. MENZIES, P,E., L.S, JAMES H. WELLMAN, P.E. November 9, 1972 R & M No. 26540-50 RALPH R. MIGLIACCIO Engineering Geologist- Mr. I/lane Finn P. O. Box 2027 Anchorage, Alaska Re: Test Hole and Soil Log Report {or Sanitary System Lot 3, Block 6, Vail-View Subdivision Dear Mr. Finn: We are submitting herewith the test boring results and ou~ comments regarding soll conditions encountered at the subject site. This investi- gation was performed in accordance with your request of November 8, 1972 and those procedures outlined in a letter dated September 13, 1971 by Mr. Stricldand of the Greater Anchorage Area Borough Department of Environmental Quality. A single test hole was put down within the Lot 3 area for the purpose of defining general subsurface soil conditions for the proposed sanitary system. Excavation was accomplished with a tractor-mounted backhoe and the test hole was extgnded to a total depth of 11 feet below ground surface. The final log prepared for the test hole has been included in Drawing A-01. Ground water was not encountered in the test hole. We appreciate being given this opportunity 5o be of service to you. Should you have any questions with regard Go the above please do not hesitate to conbact us. Very tr%~y yours, R & M ENGINEERING & GEOLOGICAL ~ James W. Rooney ~ ' IDii?I~ OF ~NVI~NMeNtA£ (tUALIyy ]WR:wb Enclosure xc: GAAB FAIRBANKS JUNEAU R&M ENGINEERING & GEOLOGICAE CONSULTANTS 229 EAST 51st. AVE. - P.O. BOX 6087 - ANCHORAGE, ALASKA 99503 TELEPHONE 907-279-0483 TELEX 090--35419 Civil Engineers Geologists Land Surveyors JAMES W. ROONEY, P, E, MALCOLM A. MENZIES, P.E,, L.S, JAMES H, WELLMAN, P.E, RALPH R. IVIIGLIACCIO Engineering Geologist_ Jartuary 3, 1973 Denise Bashaw Department of Environmental Quality 3330 "C" Street Anchorage, Alaska Re: Ulane Fir~ Soils Log Lot 3, Block 6, Vali-Vue S/d Dear Mrs. Bashaw: As per your telephone request of this date, I am enclosiug a copy of the soils log for the subject property. Very truly yours, R & M ENGINEERING & GEOLOGICAL CONSULTANTS Robert W. Huck Senior Staff Engineer RWH:wb Enclosure ANCHORAGE FAIRBANKS JUNEAU ORGANICS ORGANIC SILT W/ SOME GRAVEL SILTY SANDY GRAVEL (GM} LO' 2.0' 3.0' SANDY GRAVEL (GW) ILO' No Water Table Note: Hole excavated with tractor mounted backhoe ~nglns~Hng ~ Geological Consultontr~ Ulane Finn Property LOG OF TEST BORING Anchorage Alaska ,LcHF, o ~Y W.E.D. - 26540-50 OWG NO, DATE 11-8-72 I-~S~ I' = 2' lDWN DY G.A.W. A-01 MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section Parcel I.D. 015-123-15 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: T S 2_0 26 Complete legal description Valli Vue Estates #2, Block 6, Lot 3 Location (site address) 6621 Round Tree Drive, Anchorage, AK Current property owner(s) Joy Zimmerman Day phone 306-7526 Mailing address Real estate agent 6621 Round Tree Drive, Anchorage, AK 99507 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well R Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee & /! L Date of Payment 5-5-0 Receipt Number (X0Q__koic) COSA # G `J C lq 15 37 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone 907-522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE System #1 Approved for 4 System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms Date 7/25/2019 bedrooms, with the following stipulations: ',')i)III%�%t ,I / F r G By: `�-- Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Valli Vue Estates #2 Block 6 Lot 3 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Comments COMMUNITY WELL B. TANK DATA Age of tanks) 72511 9 years Tank type/material Septic/Plastic Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping New Construction D. ABSORPTION FIELD DATA Deep Absorption Trench Which system tested (date installed) 3/16/87 ❑ ALL standpipes present per record drawing Total measured depth from grade 14.5 ft (max) Measured depth to pipe invert from grade 6.3 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective 8.2' ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 015-123-15 Structure served by this system Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L E]Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by _ Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 6/5/19 Results IDPass For 4 bedrooms Fluid depth prior to test 0 in Water added 750 gal New depth 38 in Elapsed time 1440 min Final fluid depth 5 in Absorption rate 600+ gpd Any rejuvenation treatment (past 12 months) None If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 0 Yes Community Sewer Manhole/Cleanout > 100' ❑ Yes if No ft ❑ Yes if No Neighboring Tank > 100' ❑ Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No Absorption Field on Lot > 100' ❑ Yes if No ft Holding Tank > 100' ❑ Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' ❑ Yes if No ❑ Yes if No ft if No ft F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑ Yes if No ft 0 Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑v Yes if No ft Surface Water > 100' ft ft ft ft ft ❑✓ Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ✓❑ Yes if No ft Private Wells > 100'✓❑ Yes if No _ Water Main > 10'✓❑ v❑ Yes if No ft Community Wells > 200' ✓❑ Yes if No Water Service Line > 10' ✓❑ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' E] Yes if No ft If absorption field is under driveway comment below Property Line > 10' ✓❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10' v❑ Yes if No ft Private Wells > 100' Yes if No Water Service Line > 10' 0 Yes if No ft Community Wells > 200' R Yes if No Surface Water > 100'✓❑ Yes if No ft F. ENGINEER'S COMMENTS Septic Tank replaced 7/25/19. G. ENGINEER'S CERTIFICATION OFf/(/r� 1 certify that l have determined through field inspections and review '�.a •,° of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. ' 49th :pry rn d MICHAEL E. ANDERSON �r No. CE -438141 °,°f 8/5/19 07 tt4..a .*•``4 COSA Checklist yellow sheet PROF ESS,\ � ft M ft ft N 22'41'02"E 10.0a \ 10' DRAINAGE EASEMENTS 00 s� �`iO o° \ \ \ Lot ,2 DO, tK \ Lot SEPTIC PIPES SEPTIC MANHOLE Lot 4 4.0' DECK • • ASPHALT PAVEMENT CHAIN-LINK FENCE C / ..' LOT 31 1•p; ,y n td I ze. rn I 2 STORY o ' RESIDENCE a �' ss N I N 9.9' x 14.6' WOODEN PATIO 10.2' x 10.3' SHED--/ ' 10' UTILITY EASEMENTS PLOT PLAN AS BUILT X SCALE 1" = 30' GRID SW 2,539 Project No. 19-306/A1 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lan � Associates, ( n C® (907) 522-6476 Phone �0 (907) 522-4625 Fox — Professional Land Surveyors kenOlcngsurvey.com All OF A ( b� Jonathan0Iangsurvey.com Q;' - ...•' .. , t I hereby certify that I have surveyed the following described property: Lot 3, Block 6, VALLI VUE ESTATES UNIT No. 2 (Plat No. 77-296) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated this the Day of fiuL v eat at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. 49TH KENNETH '© A- 1-8-5 02.• AECC963 / / / / / MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL ~-')-- 1~) ] Z./' '~ OF ON-SITE SEWER AND WATER FACILITY 264-4744 1, GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) LOT D BgOCtC(~ VAL-L..I V(..'~ t 1'2..tV .,...~"~I~ , Location (address or directions) (b) Proper~y Owner y~iT.~ Mailing Address (c) Lending Institution Telephone: Home ~-O Telephone Business Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the followina address: or: Check here~ if hold for pick up. List contact person and day phone number below. CAp.. TYPE OF RESIDENCE Single-Family~ NumBer of Bedrooms 4 WATER SUPPLY Individual Well [] Community~, Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite~ Public [] Community [] Holding Tank [] Note: if community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 fRev 8/86~ Front 5. ~ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION AS certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority App royal eh owe that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is Jn compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. NameofFirm ~-~ ]~19'~ ,-'~f'Ji'~ '~OTT~ Telephone .~z~/-~i-~') Address ¢~¢ ¢ ~¢%M ~'¢ / ~¢.~¢C~ / DHHS APPROVAL Approved for bedrooms by Approved ~ Disapproved '"~ Date "~- ~-~>- ~ '~ Conditional Terms of Conditional Approval CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cedificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 IRev 8/86) Back ~ MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVIS/ONMuNICiPALiTY OF ANCHORAGE (MdA) HEALTH AUTHORITY APPROVAL (HAA) ~J~ -[ ~J ]987 CHECKLIST- FEBRUARY 1984 264-4744 RECEIVED WELL DATA Well Classification ~ Y}qJ~ g~J~ JT~ Legal Description: J~:r~'.~, ']~/~C.-J~ ~ VALL'I If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanou~/Manhole Water Sample Collected by Water Sample Test Results Comments Date Completed Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date SEPT,C/.OLD..GTA.KDATA Datelnstalied: /r. ja7 Size J~'O0~,/~ No. of Compartments ~ Standpipes (Y/N) y~ ~) Air-tight Caps (Y/N) ~ Foundation Cleanout (Y/N) Y~ Depression over Tank (Y/N) ~ Date Last Pumped ~ Pumping/Maintenance Contract on File (Y/N) ~J~ ;for ~J~ ~~ Holding Tank High-Water Alarm (Y/N) ~ Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: +tOI To Water-Supply We[I .~ ~ I To Building Foundation To Property Line + ~'O~ To Disposal Field '~ ~ To Water Main/Se~ice Line '+ [0[ To Stream, Pond, Lake, or Major Drainage Course Page 1 of 2 72-026 [Rev 8/86~ Front Soils Rating in Absorption Strata I ~20 ~-'~/'~.')~'~ Type of System Design Date Installed Width of Field Cj~_ll Square Feet of Absorption Area Depression over Field (Y/N) ~ O Results of Last Adequacy Test '- Separation Distance from Absorption Field: To Water-Supply Well ..~o To Building Foundation Lot -P l"O t To Water Main/Service Line .-¢' I ~' ~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Length of Field Depth of Field /~' Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots TO Cutbank (if present) D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I i~rave checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed U~-6c~ q4~ Date CompanY'_ '~'PJ¢~(,~'?':~<~ r~:~(~ MOA No Receipt No ~ '-~O O /-- OO 2.-.-"~ ' Date of Payment ¢ - / oC~'' -7 Amount: $ ,~_,¢") O Page 2 of 2 72 026 fRev 81861 8ack DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT DFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA g9501 274-~533 DATE: March 17, 1987 PWS I.D.# 210605 To Whom it May Concern: According to records on file in this office the VALLT VU~ Water System is in compliance with the State Drinking Water Regulations Sincerely, I~IUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF iNSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date '7/'5/8~ GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location 1(ad~Jr~e~s m: ~ireGtions) (b) Ap~ll¢~nt'Narh'~ JV[~.(~' '~}~JN~'~--(.- Telephone:Home 3/~/~'-~l(~~. Business (c) A'~.pl~ggnt i~ (bhebk'one :' Lendin~ Institution ~; Owner/buildertt~; Buyer []; Other [] (explain); (d) Lending'lnstitUt.i0rt' ,::' Address ~,~ ¢~ ~¢ ,' ' (e) Real Estate Companyand Agent Address Telephone (f) Mail the HAA to the following add~,/~ Telephone TYPE OF RESIDENCE Single-Family ~ Multi-Family [] Number of Bedrooms "~ Other WATER SUPPLY Individual Welll'-I Community~ Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status, 4. SEWAGE DISPOSAL Onsite'~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status, Page 1 of 2 72-025 (11/84) '5. ENGINEERING F RM PROVID N{~' SPECT ONS, TESTS, FILE SEARCH, DA1/-~ND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address J~(~O -~/~.~..~'"~ ..-~/[7'~~ ~'~ Telephone / DHEP APPROVAL Approved for bedrooms by Approved ~"~\ Disapproved Terms of Conditional Approval C4UTmN The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions ir~ order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MO/,,) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 MUNICIPALITY OF ANCHOP~G~. DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION WELL DATA Well Classification ' O~//~ ~JV,J ~'~/ If A, B, C, D.E.C. Approved (~N) Well Log Present (Y/N) _ Date Completed Yield Total Depth Cased to Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground Sanitary Seal On Casing (Y/N)/ Electrical Wiring in Conduit (Y/N) ./ Depression Around Well~a/~ (Y/N) Separati°n Distances fr°m Welh Lot~//~ n~t To Septic/Holding Tank on Lot ; O s __ f ~ ;On oiningLots To Nearest Edge of Absorption FieJd on ~::::sgeLw:: To Nearest Public Sewer Line o Cleanout/Manhole ~er Service Line on Lot Water Sample Collected by ~ ; Date Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed standpipes J~N) Depression over Tank (Y,~ size Air-tight Caps ~.~N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) JV//~- Separation Distances from Septic/Holding Tank: To Water-Supply Well 2-~)(~) /''/''' TO Property Line TO Water Main/Service Line J0 /'"~ Course "':,% I ()0 z _/-. Comments . No. of Compartments ~ Foundation Cleanou/t {Y~, Pate Last Pumped ,~-/,~-3/,~6 ~ /V//~- ;for NT,~ Temporary Holding Tank Permit (Y/N) -- To Building Foundation TO Disposal Field To Stream, Pond, Lake, or Major Drainage · g~l ' ' Pa of 2 - , , , 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field /3 ' Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present ~)/N) Date of Last Adequacy Test Square Feet of Absorption Area Depression over Field (Y/~ Results ol Last Adequacy Test Separation Distance from Absorption Field: -Fo Water-Supply Well '~--~)¢ / 7l'- To Building Foundalion 2~O / Lot To Water Main/Service Line .'/O /''''~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Property Line To Existing or Abandoned System on ; On Adjoining Lots -,~ ...~* /''/- To Cutbank (if present) /V/~ Ioo Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at /. /& High Water Alarm Level at _~'V// F/ Tested for '/ ~..~.J Ecl; Cmt r imCeal t~ o d e s (y/N ) Dimensions J Manhole/Access {Y/N) ~ "Pump Off..~.geve~ ./~"Ve nt (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have c)~9~d.., vgrif~ad, ouTonformed to all MC~A and¢ H,A.~,A guidelines in effect on the date of this inspection, Signed _~-~"~/-¢'_~ Date Company Page 2 of 2 72-026 (H/84) Receipt No. Date of Payment Amount: S · TO BE COI~LETED BY I~TER SUPPLIER MONTH I.D. NO. (PUBLIC 'SYSTENS) Cl*RCLE CLASS , t * I I I ) A B C WA~ OF SYSTEM TELEPHONE NUMBER TYPE,)OF SYSTEM I'1 PUBLIC~I:ZND]V~DUAL SYSTEM ADDRESS ~ CITY STATE ', ZIP CODE LOCATION WHERE SAIqPLE WA COLLECTED *COLLECTED BY: (STGNATURE TYPE OF SAMPLE (CHECK ONLY ONE THIS COLU~) ~:-ORINKING ~ATER /CHECK TREATMENT E-I CHLORINATED [-I~ILTEP~D ~NTREATED O~ OTHER I:] RAW SOURCE WATER [:3 NEW CONSTRUCTION OR REPAIRS I-I OTHER(Specify) ZS THIS SAMPLE A CHECK SAMPLE TO A PREVIOUS NON-CONFORMING SAMPLE? rl YES PREVIOUS COLLECTION DATE ANALYSIS REQUESTED (IF OTHER THAN TOTAL COLIFORH) SEND REPORT TO:(PRINT FULL HA~E,ADDRESS AND ZIP CODE I'1RESUBHIT SRNPLE Sample rejected because: CHECK ONE OR MORE [] Sample too long in transtt. Sample should not be over 30 hours. I:]Sample received too late tn week I-1Not in proper container I-1Leaked out [-] Insufficient information provided. Please read instructions on form. E-I Other (Specify) RECEIVED FROMJ~ ~ J ~Y~c~/¢/~ U¢~ DA~ ~/~/~ TZ~ /,/~ ~ ANALYTICAL ~THOD: ~MB~NE FILER ~FE~TATION TUBE - LRBOBAT~q~ R~ULTS 1-1 Other Bacteria O Test unsuitable because: [] Confluent Growth E] TNTC ~,,~SA S~.TISFACTOIIY TZSFACTO~Y [] BACTERIOLOGICAL WRTER ANALYSIS RECORO FOR LAB USE ONLY TOTAL COLT FORHS FECAL COLIFORNS OTHER Membrane Filter: Direc~ Count Verification: LTB Final Membrane Filter Results Reported By 0 BGB Date Time Col iform/lOOml Col i form/lOOml A.M. P.M. READ SAMPLE COLLECTION INSTRUCTIONS ON BACK OF FOP~ ! DEPT. OF ENVIRONMENTAL CONSERVATION / ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 BILL SHEFFIELD, GOVERNOR Telephone: (...007) Add~'e$$: 274-~533 DATE: July 11, 1986 PWS I.D.# 210605 To Whom it May Concern: According to records on file in this office the Valli-Vue Subdivision Water System is in compliance with the State Drinking Water Regulations Sincerely, ALASKA ,CligorlmerlTAL COFITROL ~n~in~rin~ g Enuironm~ntoJ MARGARET C0NNELL 6621 ROUNDTREE DRIVE ANCHORAGE ALASRA 99517 SELLER-SAME 5/23/86 MARGARET C0NNELL 6621ROUNDTREE DRIVE ANCHORAGE ALASKA 99517 60227 LEGAL:VALLI VUE #2 BLOCK 6 LOT 3 ,ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE-5/23/86 · EE TYPE OF ABSORPTION SYSTEM IS A SEEPAGE PIT WITH AN AREA OF 297 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY, THE SURGE CAPACITY OF THE SYSTEM IS 916 GALLONS, BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 8BEDROOM HOME SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS $ BEDROOM HOUSE. THE SEPTIC TANK/PACRAGE PLANT WAS PU~PED ON 5/28/86 THIS REPORT DOES NOT VERIFY THE INTEGRITY OF THE PIPING FOR THE WATER SUPPLY OR WASTEWATER SYSTEM. ALASKA ENVIRON~I~N. TAL CONTROL SERVlC, , INC. ] 200 West 33rd Avenue. Suite B ANCHORAGE, ALASKA 99503 (907) 561.5040 SHEET NO CALCULATEOSY *~T~ CHECKEDBY SC^~E I'//= 20 ' DATE DATE : = i !: 32' : - 2~'/? ' ~=~ ~ ~NICIPALIT¥ OF ANcHoRAG~E~ ~ '(~' '~ ] DEPARTM~-~;' OFstreet,HEALTH AND ENVIRONMEI !L ?ROTECTION ] 825 ~L Anchorao~. Alaska 99501 264-4720 ~1: Time Date Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Alaska National Bank of the North Mailing Address: 3301. C Street, Calais II Phone: 278-4581 2. Property Owner: Bill/Judy Hannebaum Phone: 344-9219 Mailing Address: Star Route A Box 32H 99507 3. Legal Description: Lot 3 Block 6 Valli Vue Estates Subdivision 4: Single Family Residence: (x) Number of Bedrooms: Three Multiple Family Residence: ( 5. Well System: Individual well Permit # Depth of Well Well Log on File Construction ~~ Bacterial Analysis ~ 6. Sewage Disposal System: On-site System (x) Public Utility ( ) Permit ~ Septic Tank Size Absorption Area Number of Bedrooms: () ~y/Publ~p~ SysYem ,_.~ Manufacturer~ Soils Rate ~'~ Material ~ ~" Distances: Well to septic Tank to Sewer Line Nearest Lot line to Nearest Lot Line to Absorption Area Absorption Area '~a~e~T~o Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 3 Block 6 Valli Vue Estates Subdivision Comments: (.p!, ~o~o .~$) --O]QIAOBd 39VU:tAO0 ]ONVBflSNI ON ) (a)elsod snld) ~O£--llV~ aqL-ILLUqO UO~ J. d1303~ Af fadavit Attached: Disapproved · Letter Attached: ( ) Date: Date: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-22'~1 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO ..... VA._ FHA_ - CONV._--/~--"~ 3. Name of Buyer: ...... Mailing Address: Name of Lending Ma il in g Add ress: __~,,~2~_~4' Day Phone:___ _Phone:,_ No. Bdrms._~ Water Supply Type of Supply: Public Utility. If Individual, number of dwellings presently served I nd ivid u al b2'~"-~__ If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility. If Individual, data of installation __~/~/~Z'-~ · Individual (on-site). 72 003(3/76)